Intimate Partner Violence: Continuing Education for Registered Nurses

Experiences and views of married women about domestic violence

AIM

The aim of this study was to determine the experiences and views of married women about the topic of domestic violence.

METHODS

This research was planned as a mixed methods study with an in-depth interview and descriptive approach. The study was conducted between November 2011 and December 2012 with 24 married women living in Ankara, Turkey. Two main data-collection tools were used in the study: the "Personal Information Form" and the "In-depth Interview Questionnaire." Data of this study were evaluated by content analysis.

RESULTS

A majority of the participants (83.3%) stated that they had been exposed to domestic violence that had been committed primarily by their husbands. The actual reasons for the violence were reported to be such factors as "financial problems and lack of education and love and respect between the couples." It was determined that as the victims became more desperate, they turned to reading of the Koran, prayer, and smoking.

CONCLUSION

Domestic violence adversely affects the physical and mental health of individuals, families, and the entire community. Therefore, it will take a community effort to address the causes of domestic violence and to create viable solutions that will improve the health of everyone.

Nurse and midwifery education and intimate partner violence: a scoping review

AIMS AND OBJECTIVES

This scoping review aims to identify the scope of current literature considering nurse/midwife educational practices in the areas of intimate partner violence to inform future nursing/midwifery educational policy and practice.

BACKGROUND

Intimate partner violence is a global issue affecting a significant portion of the community. Healthcare professionals including nurses/midwives in hospital- and community-based environments are likely to encounter affected women and need educational strategies that support best practice and promote positive outcomes for abused women and their families.

DESIGN

Scoping review of relevant literature from January 2000 to July 2015.

METHOD

Search of databases: CINHAL, MEDLINE, EMBASE, PROQUEST Central and COCHRANE Library. Reference lists from included articles were searched for relevant literature as were several grey literature sources.

RESULTS

This review demonstrates low levels of undergraduate or postregistration intimate partner violence education for nursing/midwifery staff and students. Existing intimate partner violence education strategies are varied in implementation, method and content. Outcomes of these educational programmes are not always rigorously evaluated for staff or client-based outcomes.

CONCLUSIONS

Further research is needed to evaluate existing intimate partner violence education programmes for nurses/midwives and identify the most effective strategies to promote improved clinical practice and outcomes for abused women and their families.

RELEVANCE TO CLINICAL PRACTICE

Intimate partner violence has a significant social and public health impact. The World Health Organization has identified the need to ensure that healthcare professionals are adequately trained to meet the needs of abused women. Intimate partner violence education programmes, commencing at undergraduate studies for nurses/midwives, need to be implemented with rigorously evaluated programmes to ensure they meet identified objectives, promote best practice and improve care for abused women.

Assessing and enhancing health care providers' response to domestic violence

This study aimed to examine possible changes from 2008 to 2012 in the skills of health care staff in identifying and intervening in domestic violence (DV). A longitudinal descriptive study design with volunteer samples (baseline; n = 68, follow-up; n = 100) was used to acquire information regarding the present state and needs of the staff in practices related to DV. The results of the baseline survey were used as a basis for planning two interventions: staff training and drafting practical guidelines. Information was collected by questionnaires from nurses, physicians, and social workers and supplemented by responses from the interviews. The data were analysed using both quantitative and qualitative methods. A chi-square test was used to test the statistical significance of the data sets. In addition, participants' quotes are used to describe specific phenomena or issues. The comparison showed that overall a small positive change had taken place between the study periods. However, the participants were aware of their own shortcomings in identifying and intervening in DV. Changes happen slowly, and administrative support is needed to sustain such changes. Therefore, this paper offers recommendations to improve health care providers' response to DV. Moreover, there is a great need for evaluating the training programme used.

How many Slovenian family practice attendees are victims of intimate partner violence? A re-evaluation cross-sectional study report

Background

Intimate partner violence (IPV) can be considered a leading public health problem affecting approximately 50% of women during the course of their lifetimes. This study was carried out with the aim of re-testing the prevalence data and providing sufficient grounds for decision-makers in family medicine in Slovenia to adopt much-needed protocols for IPV management in the field.

Methods

In January 2012, every tenth general practitioner (GP) registered in Slovenia, of a total of 958, was invited to participate in a multi-centre cross-sectional study, and 9.4% of them, working in 90 family practices, agreed to participate. From February 1 to March 1, 2012, they asked every fifth family practice attendee aged 18 years and above, regardless of gender, to participate in the study. The short version of Domestic Violence Exposure Questionnaire was administered to 2572 patients.

Results

In the sample, there were more women (62.9% (n = 1617)). The average age of all the participants was 49.0 ± 16.1 years. Of 2572 participants (95.3% response rate), 17.1% people had been exposed to either emotional or both physical and emotional abuse. The prevalence of psychological violence was 10.3%, and that of concurrent physical and psychological abuse 6.8%, with all the patients exposed to physical IPV disclosing concurrent psychological violence. Female gender and previous formal divorce were risk factors identified in all three multivariate logistic regression models. The odds of concurrent physical and psychological and either type of IPV exposure in patients were lessened by an age of 65 years or above. The odds for either type of IPV were also lower in single people, while in concurrent physical and psychological IPV exposure, living in urban settings acted as a protective factor.

Conclusions

In Slovenian family practice attendees, an IPV exposure prevalence of approximately 17% should be considered a valid estimation.

Patient opinions of screening for intimate partner violence in a fracture clinic setting: P.O.S.I.T.I.V.E.: a multicenter study

BACKGROUND

Approximately one-third of injured women presenting to fracture clinics have experienced some form of intimate partner violence in the past year. The aim of the current study was to determine patients' perceptions on screening for intimate partner violence during visits to a surgical fracture clinic.

METHODS

We conducted a cross-sectional study to evaluate patients' perceptions and opinions on screening for intimate partner violence in an orthopaedic fracture clinic. Eligible patients anonymously completed a self-reported written questionnaire, which included questions on patient demographics, attitudes toward intimate partner violence in general, the acceptability of screening for intimate partner violence in an orthopaedic fracture clinic, and opinions on how, when, and by whom the screening should be conducted.

RESULTS

The study included 750 patients (421 male and 329 female) at five clinical sites in Canada and the Netherlands. The majority (554, 73.9%) of the respondents either "agreed" or "strongly agreed" that the fracture clinic was a good place for health-care providers to ask about intimate partner violence. The majority (671, 89.5%) also agreed that health-care providers should screen for intimate partner violence by means of face-to-face interactions rather than other, more passive methods. Increased openness to screening was significantly associated with female sex, higher income, and higher education (F₃₅₉₅ = 21.950, p < 0.001).

CONCLUSIONS

Our findings demonstrated that the majority of patients endorse active screening for intimate partner violence in orthopaedic fracture clinics.

Nurses' role in caring for women experiencing intimate partner violence in the sri lankan context

Intimate partner violence has short- and long-term physical and mental health consequences. As the largest healthcare workforce globally, nurses are well positioned to care for abused women. However, their role in this regard has not been researched in some countries. This paper is based on a qualitative study that explored how Sri Lankan nurses perceive their role in caring for women who have experienced partner violence. Interviews with 30 nurses who worked in diverse clinical and geographical settings in Sri Lanka revealed that nurses' role involved: identifying abuse, taking care of patients' physical needs, attending to their safety, providing support and advice, and making referrals. Barriers to providing care included lack of knowledge; heavy workload; language barriers; threats to personal safety; nurses' status within the healthcare hierarchy; and lack of communication and collaboration between various stakeholder groups within the healthcare system. Nurses also identified a lack of appropriate services and support within hospitals and in the community. The findings reveal an urgent need for the healthcare system to respond to nurses' educational and training needs and help them function autonomously within multidisciplinary teams when caring for abused women. The findings also point to a need to address institutional barriers including the lack of appropriate services for abused women.

PRevalence of Abuse and Intimate Partner Violence Surgical Evaluation (P.R.A.I.S.E.): rationale and design of a multi-center cross-sectional study

BACKGROUND

Intimate partner violence (IPV) is described by the American Medical Association as "a pattern of coercive behaviors that may include repeated battering and injury, psychological abuse, sexual assault, progressive social isolation, deprivation, and intimidation." The long-term consequences of IPV include health risks, posttraumatic stress disorder, depression, and staggering economic costs for health care of victims. Intimate partner violence is often underreported among women who seek medical attention. The current study seeks to address the issue of possible underreporting of IPV in orthopaedic fracture clinics by establishing prevalence rates of IPV among women seeking treatment for musculoskeletal injuries.

METHODS/DESIGN

We propose a cross-sectional multicenter study wherein 3,600 women will complete a self-reported written questionnaire across clinical sites in North America, Europe, and Australia. Recruitment of participants will take place at orthopaedic fracture clinics at each clinical site. The questionnaire will contain a validated set of questions used to screen for IPV, as well as questions that pertain to the participant's demographic, injury characteristics, and experiences with health care utilization. Female patients presenting to the orthopaedic fracture clinics will complete two validated self-reported written questionnaires (Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS)) to determine the prevalence of IPV in the past 12 months and in their lifetime. The two questionnaires were designed for rapid assessment of IPV status in emergency departments, family practice, and women's health clinics that we believe are similar to our intended setting of an orthopaedic clinic.

DISCUSSION

If the prevalence of IPV among women attending orthopaedic clinics is greater than the current perceptions of orthopaedic surgeons, this study will serve to advocate for the continued education of medical professionals to better recognize probable IPV cases and offer existing services to enhance the care of these patients.

Integrating intimate partner violence content across curricula: Developing a new generation of nurse educators

Abuse between intimate partners can take many forms. Prevalence data analyses confirm that intimate partner violence (IPV) is a widespread problem. Meeting the objectives of World Health Organization's "Global Campaign on Violence Prevention" will involve many organizations and institutions within and beyond the health care community. Educating prospective Nurse Educators about IPV does, however, present challenges, as most nurses lack awareness of IPV as a public health problem, have limited knowledge and erroneous beliefs about IPV, and are inexperienced in caring for survivors of IPV. Thus providing formal education and training in a supportive environment will enhance Nurse Educators' knowledge and skills about IPV while helping them to examine the benefits and limitations of various pedagogical approaches for teaching this critical content to students. Hence targeting educational efforts at nurses who are pursuing the academic role is an important first step toward raising the collective consciousness of nurses to the point that IPV education becomes an integral component of the nursing curriculum, and competence in caring for IPV survivors becomes the standard rather than the exception.

Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurses

BACKGROUND

Intimate partner violence against women (IPV) has been identified as a serious public health problem. Although the health care system is an important site for identification and intervention, there have been challenges in determining how health care professionals can best address this issue in practice. We surveyed nurses and physicians in 2004 regarding their attitudes and behaviours with respect to IPV, including whether they routinely inquire about IPV, as well as potentially relevant barriers, facilitators, experiential, and practice-related factors.

METHODS

A modified Dillman Tailored Design approach was used to survey 1000 nurses and 1000 physicians by mail in Ontario, Canada. Respondents were randomly selected from professional directories and represented practice areas pre-identified from the literature as those most likely to care for women at the point of initial IPV disclosure: family practice, obstetrics and gynecology, emergency care, maternal/newborn care, and public health. The survey instrument had a case-based scenario followed by 43 questions asking about behaviours and resources specific to woman abuse.

RESULTS

In total, 931 questionnaires were returned; 597 by nurses (59.7% response rate) and 328 by physicians (32.8% response rate). Overall, 32% of nurses and 42% of physicians reported routinely initiating the topic of IPV in practice. Principal components analysis identified eight constructs related to whether routine inquiry was conducted: preparedness, self-confidence, professional supports, abuse inquiry, practitioner consequences of asking, comfort following disclosure, practitioner lack of control, and practice pressures. Each construct was analyzed according to a number of related issues, including clinician training and experience with woman abuse, area of practice, and type of health care provider. Preparedness emerged as a key construct related to whether respondents routinely initiated the topic of IPV.

CONCLUSION

The present study provides new insight into the factors that facilitate and impede clinicians' decisions to address the issue of IPV with their female patients. Inadequate preparation, both educational and experiential, emerged as a key barrier to routine inquiry, as did the importance of the "real world" pressures associated with the daily context of primary care practice.